subject_line
Quarterly Technical Assistance Request for Payment
FY 2023 Quarterly Cost Share Technical Assistance Request for Payment
District
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Alamance
Alexander
Alleghany
Anson(Brown Creek)
Ashe
Avery
Beaufort
Bertie
Bladen
Brunswick
Buncombe
Burke
Cabarrus
Caldwell
Camden
Carteret
Caswell
Catawba
Chatham
Cherokee
Chowan
Clay
Cleveland
Columbus
Craven
Cumberland
Currituck
Dare
Davidson
Davie
Duplin
Durham
Edgecombe
Forsyth
Franklin
Gaston
Gates
Graham
Granville
Greene
Guilford
Halifax(Fishing Creek)
Harnett
Haywood
Henderson
Hertford
Hyde
Iredell
Jackson
Johnston
Jones
Lee
Lenoir
Lincoln
Macon
Martin
McDowell
Mecklenburg
Madison
Mitchell
Montgomery
Moore
Nash
New Hanover
Northampton
Onslow
Orange
Pamlico
Pasquotank
Pender
Perquimans
Person
Pitt
Polk
Randolph
Richmond
Robeson
Rockingham
Rowan
Rutherford
Sampson
Scotland
Stanly
Stokes
Surry
Swain
Transylvania
Tyrrell
Union
Vance
Wake
Warren
Washington
Watauga
Wayne
Wilkes
Wilson
Yadkin
Yancey
PY2021 Master Agreement Number
21 - 035 -
Period Covered by this request (select all that apply)
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1st Quarter {July 1, 2022 - September 30, 2022}
2nd Quarter {October 1, 2022 - December 31, 2022}
3rd Quarter {January 1, 2023 - March 31, 2023}
4th Quarter {April 1, 2023 - June 30, 2023}
Yearly {July 1, 2022 - June 30, 2023}
Submitted By:
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Title
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District Employee
County Finance
Email address
*
Phone:
*
Budget Catagories:
Salary/Benefits
*
Mileage:
Equipment:
Employee Travel Cost:
Other Operating Expenses:
Current Total:
0.00
Calculate
Upload
Current Expended
County budget for your District for time period you are billing for (this should be an official report from your county finance to show the salary and expenses paid out)
*
Comments or Additional Information:
Please email Paula.Day@ncagr.gov or call 919-707-3786 with any questions or concerns.
Signature
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